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Biomedical subjects

Abdullah M Kaki

Publications and source records attributed to Abdullah M Kaki.

7 recordsLinked to original sources
PubMed2006

Intravenous acetaminophen vs oral ibuprofen in combination with morphine PCIA after Cesarean delivery.

PURPOSE: To compare the effects of iv acetaminophen with those of oral ibuprofen with respect to postoperative pain control and morphine requirements in patients receiving morphine patient-controlled iv analgesia (PCIA) after Cesarean delivery. METHODS: Forty-five term patients scheduled for Cesarean delivery were randomized to receive acetaminophen 1 g iv every six hours plus oral placebo (group A) or ibuprofen 400 mg po every six hours plus iv placebo (group I); the first dose of study drug was given 30 min preoperatively. Postoperatively, all patients received PCIA for 48 hr using morphine bolus dose 2 mg iv, lockout interval ten minutes, and no basal infusion. Visual analogue scale (VAS; 0 to 10) at rest and morphine requirements were recorded every hour for four hours then every four hours for a total of 48 hr postoperatively. Patient satisfaction was recorded on a ten-point scale (from 1 to 10) 48 hr postoperatively. RESULTS: Visual analogue scale scores decreased similarly in both groups over time, however, there were no differences between groups at any time during the study period (estimated marginal means: 1.4 +/- SEM 0.2 vs 1.9 +/- SEM 0.2 for groups A and I, respectively, P = 0.124). Cumulative doses of postoperative morphine were 98 +/- 37 vs 93 +/- 33 mg for groups A and I, respectively (P = 0.628). Patient satisfaction with analgesia was high in both groups (9 +/- 1 vs 9 +/- 1, P = 0.93). CONCLUSION: Intravenous acetaminophen is a reasonable alternative to oral ibuprofen as an adjunct to morphine patient-controlled analgesia after Cesarean delivery.

Acetaminophen↗
PubMed2006

Anesthesiologist-controlled versus patient-controlled propofol sedation for shockwave lithotripsy.

PURPOSE: To compare anesthesiologist-controlled sedation (ACS) with patient-controlled sedation (PCS), with respect to propofol requirements, sedation, and recovery, in patients undergoing extracorporeal shockwave lithotripsy for urinary calculi. METHODS: Sixty-four patients were randomized, in this double-blind study, to receive propofol sedation according to one of two regimens: infusion of 200 microg.kg(-1) .min(-1) for ten minutes reduced thereafter to 50-150 microg.kg(-1) .min(-1) titrated by an anesthesiologist, according to patient response (group ACS), or propofol administered by patient-controlled analgesia (bolus dose 300 microg.kg(-1), lockout interval three minutes, no basal infusion), (group PCS). All patients received midazolam 10 microg.kg(-1) iv and fentanyl 1 microg.kg(-1) iv preoperatively, followed by fentanyl infused at a rate of 0.5 microg.kg(-1) .hr(-1) throughout the procedure. Sedation and analgesia were assessed using the A-line ARX index and visual analogue scale, respectively. Psychomotor recovery and readiness for recovery room discharge were assessed using the Trieger dot test and postanesthesia discharge score, respectively. Patient satisfaction was assessed on a seven-point scale (1-7). RESULTS: In comparison to group PCS, patients in group ACS received more propofol (398 +/- 162 mg vs 199 +/- 68 mg, P < 0.001), were more sedated (A-line ARX index: 35 +/- 16 vs 73 +/- 16, P < 0.001), experienced less pain (visual analogue scale: 0 +/- 0 vs 3 +/- 1, P < 0.001), and were more satisfied (median [Q1, Q3]: 7 [7, 7] vs 6 [6, 7], P < 0.001). In contrast, patients in group PCS had faster psychomotor recovery (Trieger dot test median [Q1, Q3]: 8 [4, 16] vs 16 [12, 26] dots missed, P = 0.002) and achieved postanesthesia discharge score >/=9 earlier (median [Q1, Q3]: 40 [35, 60] vs 88 [75, 100] min, P < 0.001) compared with group ACS. CONCLUSION: In comparison to PCS for patients undergoing extracorporeal shockwave lithotripsy, propofol/fentanyl ACS is associated with increased propofol administration, deeper sedation levels, and greater patient comfort. However, ACS is associated with slower recovery and a longer time to meet discharge criteria, when compared to PCS.

Adjuvants, Anesthesia↗
PubMed2006

Pain clinic experience in a teaching hospital in Western, Saudi Arabia. Relationship of patient's age and gender to various types of pain.

OBJECTIVE: To show the practice of a pain clinic in Saudi Arabia, to estimate the prevalence of various types of chronic pain managed in there and to find the relationship of patient's age and gender to type of pain. METHODS: A retrospective study was carried out over a period of 5 years (January 2000 - December 2004) at a teaching hospital in Jeddah. A total of 1686 patient's data was reviewed, including the giving diagnosis, types of pain and demographic data. RESULTS: The common age was 50-59 years (25.4%), with a preponderance of female (56.8%) over male (43.2%). For given diagnosis low back pain (LBP) was the most common (45.4%), followed by painful neuralgia (15.6%), headache (9.7%), cancer pain (8.7%), and cervicobrachialgia (8.1%). The prevalence of fibromyalgia (7.9%), headache (12.1%) and cervicobrachialgia (10.7%) was more common among female, in comparison to male (2.4%), (6.4%) and (4.7%) respectively. While painful neuralgia was more frequent among male (19.9%) than female (12.3%), (p<0.001). Low back pain showed higher prevalence among old patients, while headache and sickle cell disease were more common among younger age group. Combined nociceptive and neuropathic pain was the most common pathophysiological type observed (39%), followed by nociceptive pain (36.2%) and the least one was psychological pain (2.7%). CONCLUSION: Various types of chronic pain managed in the pain clinic requesting full understanding of pain neurophysiology as well as familiarity with contributing factors to the prevalence of pain.

Adult↗
PubMed2004

Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy.

PURPOSE: To compare the analgesic effects of dexmedetomidine/morphine with those of tramadol/midazolam in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for urinary calculi. METHODS: Sixty patients were randomized to receive either dexmedetomidine 1 micro g*kg(-1) iv followed by 0.5 micro g*kg(-1)*hr(-1) infusion together with morphine patient-controlled analgesia [(PCA); 2 mg bolus, five minutes lockout, 2 mg*hr(-1) infusion; (Group DEX)], or tramadol 1.5 mg*kg(-1) pre-mixed with midazolam 30 micro g*kg(-1) iv followed by tramadol PCA [20 mg bolus, five minute lockout, 20 mg*hr(-1) infusion; (Group TRA)]. Pain was assessed at baseline and every 15 min thereafter. Patients' and urologist's satisfaction with analgesia and sedation were determined on a seven-point scale ranging from 1 (extremely dissatisfied) to 7 (extremely satisfied). Patient's discharge time was also documented. RESULTS: Visual analogue scale scores over time were consistently lower in Group DEX compared with Group TRA (P = 0.001). Patients' satisfaction with analgesia (5 +/- 1 vs 4 +/- 2, P = 0.012) and with sedation (6 +/- 1 vs 5 +/- 1, P = 0.020), and urologist's satisfaction (6 +/- 1 vs 4 +/- 2, P = 0.001) were all higher amongst Group DEX patients compared with Group TRA. There was no difference between discharge times of patients in Group DEX compared with those in Group TRA [85 (60,115) min vs 65 (40,95) min, P = 0.069]. CONCLUSION: Dexmedetomidine in combination with morphine PCA provided better analgesia for ESWL and was associated with higher patients' and urologist's satisfaction when compared with a tramadol/midazolam PCA combination.

Adult↗
PubMedDate not supplied

Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale.

BACKGROUND AND OBJECTIVES: Although the literature contains information about prevalence and incidence of low-back pain (LBP), little information is available about the contribution of the neuropathic element to LBP. Our study was designed to investigate the prevalence of neuropathic pain among a sample of chronic LBP patients in Saudi Arabia by use of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale. METHODS: A total of 1,169 patients from 117 centers agreed to participate in the study over a period of 6.5 months. The LANSS pain scale was applied to each patient in an interview format. The characteristics of pain and sensory dysfunction were tested and recorded. RESULTS: According to the LANSS pain scale, 639 patients (54.7%) had scores of 12 points or more, which suggested a neuropathic type of pain, and 530 patients (45.3%) had scores of less than 12, which suggested a nociceptive type of pain. Factors that are associated with neuropathic pain are advanced age, female gender, increased height, white race, hypertension and diabetes, a history of smoking, previous back surgery, and previous medications. CONCLUSION: Neuropathic pain is a major contributor to chronic LBP, and the LANSS pain scale is a useful tool to distinguish patients with neuropathic pain from those with nociceptive pain.

Adolescent↗